Highlights the need for alternative research approaches, such as hermeneutic reviews and naturalistic study designs, to understand the limited adoption of telehealth in heart failure.
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Complex barriers limit telehealth uptake in heart failure; challenges RCT-centric approaches and supports naturalistic designs plus hermeneutic reviews.
The limited adoption of telehealth for heart failure has complex clinical, professional and institutional causes, which are unlikely to be elucidated by adding more randomised trials of technology-on versus technology-off to an already-crowded literature. An alternative approach is proposed, based on naturalistic study designs, application of social and organisational theory, and co-design of new service models based on socio-technical principles. Conventional systematic reviews (whose goal is synthesising data) can be usefully supplemented by hermeneutic reviews (whose goal is deepening understanding).
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Greenhalgh et al. (2017) studied this question.
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